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Cureus May 2024There are two main treatment options for immature teeth with necrotic pulp and apical periodontitis. Apexification creates a mineralized tissue barrier, while... (Review)
Review
There are two main treatment options for immature teeth with necrotic pulp and apical periodontitis. Apexification creates a mineralized tissue barrier, while revitalization aims to regenerate vital tissue in the canal space. There is no conclusive evidence to determine the most effective procedure regarding root length and dentin wall thickness. The objective of this systematic review was to compare the outcomes of revitalization and apexification procedures in immature non-vital teeth in terms of root length and dentin wall thickness. A literature search was conducted using the PubMed, ScienceDirect, Google Scholar, and Embase databases. Articles relevant to the study topic were gathered according to the selection criteria, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The included studies had to be published in English, conducted over a six-year period, and compared the outcomes of revitalization and apexification procedures in immature non-vital teeth. Data were collected using appropriate keywords from the eligible studies. Six articles were included for qualitative and quantitative analysis. The eligible studies showed a low risk of bias. In all revitalization cases, the root length increased significantly (mean difference (MD) (%) = 5.91; 95% confidence interval (CI) = 2.39-9.43; p = 0.0010; MD (mm) = 2.43; 95% CI = 2.05-2.80; p < 0.00001). The dentin wall thickness was statistically significant in most cases (MD (%) = 10.94; 95% CI = 7.01-14.88; p < 0.00001), MD (mm) = 0.16; 95% CI = 0.07-0.25; p = 0.0007). The systematic review and meta-analysis showed both procedures to be credible treatment options for necrotic immature teeth. Apexification had a positive impact, to some extent, on the development of root length. Revitalization yielded a significantly greater increase in root length and root dentin wall thickness and appeared to be superior in promoting root development.
PubMed: 38883120
DOI: 10.7759/cureus.60357 -
Journal of Pharmacy & Bioallied Sciences Apr 2024To evaluate the effect of lasers on the shear bond strength of Giomer and G-aenial flo composite using three different etching techniques.
AIM
To evaluate the effect of lasers on the shear bond strength of Giomer and G-aenial flo composite using three different etching techniques.
MATERIALS AND METHODS
60 Samples (extracted human premolar teeth) are cut horizontally using a diamond disk to expose a flat occlusal surface involving enamel and dentin. On exposed occlusal surfaces, etching is done by various methods. These were divided into six groups of ten samples each as follows: group I (acid etched for Giomer), group II (acid etched for G-aenial flo composite), group III (laser etched for Giomer), group IV (Laser etched for G-aenial flo composite), group V (air abrasion etched for Giomer), group VI (Air abrasion etched for G-aenial flo composite). Then, restorative material is placed and cured with light for 20 seconds. The samples were thermocycled to simulate the oral environment. The samples were subjected to a universal testing machine for bond strength testing at a cross-head speed of 3 mm/min until the restoration will fracture.
RESULTS
The intergroup comparison between both the materials using Student's -test gives insignificant results. The intergroup comparison between different etching techniques using two-way ANOVA tests gives insignificant results.
CONCLUSION
Within the limitation of this study, it can be concluded that Giomer and G-aenial flo composite achieved the same shear bond strength in all the etching techniques.
PubMed: 38882892
DOI: 10.4103/jpbs.jpbs_797_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Marginal failure at the resin dentin interface promotes biofilm formation, which further leads to secondary caries and hypersensitivity. This likelihood also increases...
BACKGROUND
Marginal failure at the resin dentin interface promotes biofilm formation, which further leads to secondary caries and hypersensitivity. This likelihood also increases if residual bacteria are present following cavity preparation. In order to achieve a proper biological seal without jeopardizing bonding, efforts were made to functionalize the adhesive system with antibacterial activity. Aim and objectives: To appraise the antibacterial activity of a total-etch adhesive system against . mutans with and without incorporation of antibiotics Vancomycin and Cefotaxime.
MATERIALS AND METHOD
A commercially available 5th-generation total-etch bonding agent (Te-Econorm) was used. S. mutans broth had been standardized and streaked over Muller-Hinton agar culture medium and round wells about 6 mm in diameter were made in the centre of the agar plates. Each experimental group comprised 10 samples, which include: Group 1 - 30µg Cefotaxime, Group 2- 30µg Cefotaxime + Bonding agent, Group 3- 30µg Vancomycin, Group 4- 30µg Vancomycin + Bonding agent, Group 5- Bonding agent, and Group 6- No material. Inoculated culture plates were examined for the zone of inhibition after incubation at 37° C for 24 hours.
RESULTS
There was a significant difference in the mean diameter of zone of inhibition (=0.000), with the maximum exhibited by Group 4, followed by Group 3 and Group 2. The least zone of inhibition was exhibited by Groups 1 and 5. The negative control showed no zone of inhibition.
CONCLUSION
The combination of Vancomycin and bonding agent had superior antibacterial activity against S. mutans in comparison to cefotaxime and bonding agent.
PubMed: 38882884
DOI: 10.4103/jpbs.jpbs_1046_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Complex anatomy of the root canal system results in incomplete debridement with mechanical instrumentation, leaving some areas or root canal walls untouched. There comes...
INTRODUCTION
Complex anatomy of the root canal system results in incomplete debridement with mechanical instrumentation, leaving some areas or root canal walls untouched. There comes the significance of endodontic irrigants with residual antibacterial substantivity which prolongs the post-antibiotic effect, thereby improving the success and predictability of endodontic treatment.
AIM
To comparatively evaluate the residual antibacterial substantivity of 2% chlorhexidine, Biopure MTAD and 2% chitosan against at intervals of 1, 14 and 28 days.
MATERIALS AND METHODS
Seventy-five therapeutically extracted permanent single rooted mandibular premolars teeth were selected. Dentin blocks of 4 mm thickness were prepared and enlarged to 1.6 mm. The autoclaved blocks were inoculated with 24-hour colonies of pure cultures of for 14 days. After the contamination period, canals of each dentin block were irrigated with 5 ml of sterile saline and dried with sterile paper points. A total of 75 dentin blocks were randomly divided into five groups as follows: Group A (21 specimens): 2% chlorhexidine, Group B (21 specimens): Biopure MTAD, Group C (21 specimens): 2% chitosan, Group D (6 specimens): positive control (infected dentin tubes) and Group E (six specimens): negative control (sterile dentin tubes). Then, the lumens of dentin blocks were irrigated with the respective irrigants for 10 mins and were dried using sterile paper points. The specimens were then incubated at 37°C for 28 days to maintain humidity. At experimental intervals of 1, 14 and 28 days, dentin shavings were removed from the canals of respective groups by circumferential filing with sterile no. 35 Hedstrom files. The powdered dentin samples obtained with each dentin block were observed for colony forming units (CFUs) using a Digital Colony counter and were expressed as CFUs/mL.
RESULT
All the irrigants in the study showed a significant decrease in CFUs from day 1 to day 28 indicating that they have residual antibacterial substantivity against . Group B (Biopure MTAD) showed significantly least mean CFUs compared to Group A (2% CHX) and Group C (2% chitosan) against at B1(day 1), B2(day 14) and B3(day 28). Group A (2% CHX) showed significantly higher mean CFUs than Group C (2% chitosan) at A1(day 1). Group C (2% chitosan) showed significantly higher mean CFUs compared to Group A (2% CHX) at C2(day 14) and C3 (day 28).
CONCLUSION
MTAD showed statistically higher residual antibacterial substantivity against at experimental periods of 1, 14 and 28 days. The residual antibacterial effect of 2% chitosan was better compared to 2% CHX at day 1. The residual antimicrobial substantivity of 2% CHX was higher compared to 2% chitosan at intervals of 14 and 28 days.
PubMed: 38882860
DOI: 10.4103/jpbs.jpbs_693_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The longevity of an endodontically treated tooth depends on fracture resistance by preserving more remaining dentin thickness. The aim of this study is to determine...
Comparative Evaluation of Efficiency of Different Endodontic File Systems; Protaper Universal, MTWO, Protaper Next, Trunatomy, I-Race in Terms of Remaining Dentin Thickness: An CBCT Analysis.
INTRODUCTION
The longevity of an endodontically treated tooth depends on fracture resistance by preserving more remaining dentin thickness. The aim of this study is to determine which file system preserves more remaining dentin thickness.
MATERIALS AND METHODS
Protaper universal, M-two, Protaper Next, Trunatomy, I-Race and mandibular first premolar. The removed dentin thickness during instrumentation of each file system was noted by taking the difference of RDT of pre-instrumentation and post-instrumentation with the aid of CBCT.
RESULTS AND DISCUSSION
TRN [Group-4] shows the least aggressive cutting with maximal preservation of remaining dentin thickness at 3 mm and 6 mm from the apex at both mesiodistal and buccolingual dimensions. M-two [Group-2] shows maximum removed dentin thickness at 3 mm from the apex both mesiodistal dimension and buccolingual dimension. PTU [Group-1] shows maximum removed dentin thickness at 6 mm from the apex at mesiodistal dimension. M-two [Group-2] shows maximum removed dentin thickness at 6 mm from the apex at the buccolingual dimension.
CONCLUSION
In this study, it is concluded that the Trunatomy file system preserves more remaining dentin thickness both mesiodistally and buccolingually both 3 mm and 6 mm from the apex.
PubMed: 38882834
DOI: 10.4103/jpbs.jpbs_697_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Conservative caries removal has become an integral part of minimally invasive dentistry (MID). Polymer and Cera burs are two feasible MID methods. The aim of the study...
Conservative caries removal has become an integral part of minimally invasive dentistry (MID). Polymer and Cera burs are two feasible MID methods. The aim of the study was to compare the efficiency of Polymer, Cera, and Tungsten carbide bur in dentin caries excavation of mandibular primary molars. 45 children in the age group of 6-8 years with dentin caries, not involving pulp in the second mandibular primary molars, were selected for the study. The three burs compared were polymer bur, Cera bur, and Tungsten Carbide bur. The excavation of carious lesion was performed with each burs using a slow-speed handpiece with 500-1000rpm. Caries removal efficiency was evaluated using the Visual-Tactile method and confirmed Dye detection method. The time taken to complete the caries removal was measured using a stopwatch. The patient's pain perception was assessed using the Wong-Baker Faces Pain Rating Scale. The intergroup comparisons based on time, dye, and Wong-Baker Faces Pain Rating Scale (WBFPRS) were arrived at using Mann-Whitney and Fisher Exact tests at < 0.0001. A statistical significance between the three groups on the time taken for caries removal at < 0.0001. No statistical significance was observed between the three groups for caries removal efficiency and pain perception using the dye and WBFPRS scores at > 0.001. Cera burs had shown high caries removal efficiency, which had taken less time in the excavation, with reduced pain perception followed by Tungsten Carbide bur and the polymer bur in mandibular primary molars.
PubMed: 38882818
DOI: 10.4103/jpbs.jpbs_842_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The electrochemical dissolution method of instrument retrieval emphasizes on the dissolution of the instrument rather than sacrificing dentine. Most of the studies...
OBJECTIVE
The electrochemical dissolution method of instrument retrieval emphasizes on the dissolution of the instrument rather than sacrificing dentine. Most of the studies conducted for electrochemical dissolution used fluoride-containing electrolytes and were performed inside a beaker. In this study, we used chloride-based fluids as electrolytes.
MATERIALS AND METHODS
Fifty extracted mandibular first premolars were divided into five groups based on the electrolytes used. Canals were enlarged to ProTaper Universal F2, and files were intentionally broken inside the canal. These specimens were subjected to electrochemical characterization by applying the potential of 9V for 20 min. Optical images were taken to assess the change in surface topography. The results were analyzed statistically by one-way analysis of variance (analysis of variance [ANOVA]).
RESULTS
The rate of dissolution based on the electrolyte used decreased in the following order, viz. Tyrode's solution>artificial saliva>normal saline>Ringer's lactate/physiological serum.
CONCLUSION
Apart from fluoride, chloride-based electrolytes could be an efficient alternative.
PubMed: 38882790
DOI: 10.4103/jpbs.jpbs_1225_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Bioactivity refers to the ability of a material to interact with living organisms or biological systems in a way that elicits a specific response. In the context of...
BACKGROUND
Bioactivity refers to the ability of a material to interact with living organisms or biological systems in a way that elicits a specific response. In the context of materials science and medicine, bioactivity is particularly important because it can determine the suitability of material for various applications.
OBJECTIVE
To evaluate and compare different commercially available calcium silicate-based materials regarding: 1. Morphological and elemental analysis at the dentin/material interface. 2. Calcium and silicon release and uptake by adjacent root canal dentine by evaluating the calcium and silicon incorporation depth in adjacent root canal dentin.
MATERIALS AND METHODS
This study examined four calcium silicate-based cements: Biodentine, MTA Angelus, BioAggregate, and MTA Plus. One hundred extracted human teeth with intact apices and no cavities were selected. Root sections measuring 3 mm in length were created at the mid-root level using low-speed diamond discs. Bioactivity was evaluated at 1, 7, 30, and 90 days, respectively.
RESULTS
The principal composition of the interfacial dentine layer and incorporation of calcium and silicon into dentine was measured at 1, 7, 30, and 90 days. Statistical analysis was performed by multiple comparisons using Tukey HSD.
CONCLUSION
All the materials have shown bioactivity, i.e. release of calcium, silicon, and their uptake in the adjacent dentin in the presence of phosphate-buffered saline.
PubMed: 38882788
DOI: 10.4103/jpbs.jpbs_959_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024To assess and contrast the depth of penetration of conventional calcium hydroxide, nanoparticle calcium hydroxide, silver nanoparticles, and combination of nanoparticle...
BACKGROUND
To assess and contrast the depth of penetration of conventional calcium hydroxide, nanoparticle calcium hydroxide, silver nanoparticles, and combination of nanoparticle calcium hydroxide and silver nanoparticles into dentinal tubules using confocal laser scanning microscope.
MATERIALS AND METHODS
Eighty human single-rooted teeth were decoronated and instrumented up to Protaper Universal F3. Teeth were separated into four groups at random ( = 20) following chemomechanical preparation. Group 1: Control Conventional Calcium Hydroxide; Group 2: Nanoparticle Calcium Hydroxide; group 3: Silver Nanoparticles; group 4: Combination of Nanoparticle Calcium Hydroxide and Silver Nanoparticles. With the use of lentulo spirals, medications were injected into the canals, stirred up with ultrasound, and then kept at 37°C for 24 hours. A 1 mm thick slice was obtained at 5 mm from the root apex by sectioning the root perpendicular to the long axis of the tooth and then put on a glass slide to measure the depth of penetration using a confocal laser microscope.
STATISTICAL ANALYSIS
To quantify the depth of penetration among the four groups, a one-way ANOVA was used and post hoc-Tukey's test was used to compare between groups.
RESULTS
All of the groups were statistically significant, with group 4 showing the greatest depth of penetration, followed by group 2 and group 3. In contrast, all other groups in the intergroup comparison were statistically significant ( value 0.05) aside from the comparison of group 2 to group 3.
CONCLUSION
Silver nanoparticles and nanoparticle calcium hydroxide together demonstrated greater penetration than calcium hydroxide, silver nanoparticles, and nanoparticle calcium hydroxide alone.
PubMed: 38882763
DOI: 10.4103/jpbs.jpbs_942_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024To assess clinically and histologically the efficacy of TheraCal LC and Biodentine as Direct Pulp Capping agents.
AIM
To assess clinically and histologically the efficacy of TheraCal LC and Biodentine as Direct Pulp Capping agents.
MATERIALS AND METHOD
Sixty caries-free maxillary first premolar teeth which were scheduled for orthodontic extraction were selected for the study and were divided equally into Group 1 (Theracal LC) and Group 2 (Biodentine). Thermal and electric pulp testing was performed on the teeth to assess pulp vitality followed by tooth preparation to expose pulp horns under local anesthesia. After achieving hemostasis, the direct pulp capping agent was placed and composite restoration was done. All the teeth were evaluated and compared in terms of clinical and histological findings after 6 weeks. The statistical analysis used was the Kruskal-Wallis test.
RESULTS
Teeth with Theracal LC showed no sensitivity to heat, cold, or percussion, whereas sensitivity to heat, cold, or percussion was noted with Biodentine. Histological evaluation revealed that TheraCal LC has higher efficiency in complete dentin bridge formation, had maximum dentin thickness, and showed minimal or no pulpal disorganization and pulpal inflammation as compared to Biodentine.
CONCLUSION
TheraCal LC proves to be a promising future as a direct pulp capping agent.
PubMed: 38882760
DOI: 10.4103/jpbs.jpbs_805_23